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Out On The Couch

Substance Use Disorders in LGBTQIA+ Youth

Posted: 9-14-22 | Tayler Rose, MA

*Content warning: eating disorders, substance use disorders in LGBTQIA+ youth

LGBTQIA+ youth are more susceptible to developing a substance use disorder than people not in this group (Garcia et al., 2019). Affirming therapists must be cognizant that LGBTQIA+ clients are more likely to make impulsive decisions and have a high rate of dysphoria around body [...]

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Red & Green Flags of Emotional Safety

 Rainbow flags stand as one of the hallmarks of the LGBT community, symbolizing colorful celebrations of life, nature, sunlight, and spirit, amongst other positive notions (Gilbert Baker Foundation, n.d). However, as we consider emotional safety in queer relationships, it’s imperative that we recognize certain other “flags,” some of which dictate the need for increased boundaries, [...]

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How to make your practice more CNM affirmative

Posted: 8-10-22 | Andrew Kravig

As a young therapist intern, I once had a supervisor ask me what the difference was between “an open relationship and just screwin’ around.” I had to spend almost the full two hours of that group supervision meeting educating my supervisor and fellow interns about the nuances of consensual non-monogamy (CNM). I argued that  an [...]

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Eating Disorders with LGBTQIA+ Youth

Posted: 8-2-22 | Tayler Rose, MA

 *Content warning: eating disorders, sexual assault, aggressive behaviors

The intersection of eating disorders with LGBTQIA+ youth is a challenging presentation to treat. A therapist’s chief concern is that eating disorders have a higher mortality rate than any other mental health disorder (Edakubo & Fushimi, 2020). Secondly, people in the LGBTQIA+ community  have a high rate [...]

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Gender Pronouns: Key Things Therapists Should Know

Posted: 7-20-22 | Andrew Kravig

Gender pronouns are an essential part of understanding how an individual identifies and communicating with them appropriately. As a therapist, using the correct gender pronouns for your clients will elevate your practice by helping them feel both seen and heard. If you don’t identify as trans or gender non-binary (TGNB) yourself, it can be hard [...]

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5 Challenges Facing the LGBTQ+ Community

Posted: 6-29-22 | Andrew Kravig

The fight for LGBTQ+ rights has come a long way, but the battle for acceptance is far from over. Therapists working with clients who are members of the LGBTQ+ community commonly see elevated rates of mental health challenges in this population, including anxiety, depression, trauma, disordered eating, and even suicidal ideation (Young & Fisher-Borne, 2018). Many [...]

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Mental Health Outcomes of Gender-Affirming Care

In recent years, both the ethics and efficacy of affirmative mental healthcare have been debated on a national stage. In 2022 alone, Florida state legislators have proposed a “Don’t Say Gay” bill, Alabama passed a law outlawing gender-affirming medical or mental healthcare for teens, and more than a dozen states like Ohio have followed in [...]

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The Trauma Impact of Cancel Culture

Posted: 3-30-22 | Amelia Ortega

 

 Over the last two years of the COVID-19 pandemic, community relationships have shifted  to a location primarily online. The centrality and importance of technology-mediated relationships is now an established interest within the fields of social work and psychology (Trepte et al., 2017, Okdie et al., 2018) along with social and relational conflicts like cancel [...]

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Working With LGBTQIA+ Clients: What Therapists Should Know

Posted: 3-30-22 | Andrew Kravig

As a therapist, your first priority is understanding your clients’ needs. This is no less true when working with LGBTQIA+ clients. Many therapists have distanced relationships with the LGBTQIA+ world.  Some clinicians do not feel the need to explore LGBTQIA+ experience and identity. This lack of exposure threatens to hinder your work with members of [...]

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Deconstructing Compulsory Heterosexuality in Psychotherapy

A key aspect for therapists practicing affirmative psychotherapy is deconstructing heteronormativity. Defined by the American Psychological Association as “the assumption that heterosexuality is the standard for defining normal sexual behavior,” heteronormativity stems from a long-standing, embedded cultural belief that traditional gender roles are unchanging and omnipotent. (2022) Taken a step further, heteronormativity becomes compulsory heterosexuality [...]

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How online self-disclosure benefits LGBTQIA+ therapists with lived experience

Posted: 2-18-22 | Teresa Theophano

Self-Disclosure and Community Building

We know that LGBTQIA+ community members are resourceful and resilient. We also know about startling disparities in the mental health of queer and trans individuals v. that of cisgender and heterosexual ones. As a queer femme clinical social worker who has spoken openly and published about my own lived experience of [...]

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5 Ways To Create a Welcoming Space for LGBTQIA+ Clients

Posted: 1-18-22 | The Affirmative Couch

Are you a mental health professional wondering how to make your office an LGBTQIA+ friendly space? Providing an inclusive space where LGBTQIA+ clients feel welcome can help them open up and feel comfortable seeking care. To help you craft an open environment where your clients can freely be themselves, here are five ways to create a welcoming space for LGBTQIA+ clients.

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Self Disclosure of the Polyamorous Therapist

Posted: 1-12-22 | Mandy Simmons

As the mental health field makes inroads toward inclusive and equitable practice, efforts to understand the needs of polyamorous people are expanding beyond the basics (Johnson, 2013). Moreover, it is important to ensure polyamorous therapists are included in that discussion. As practitioners, we are examining ourselves for opportunities to better meet the needs of [...]

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5 Essential Self-Care Tips for Psychotherapists

Posted: 12-17-21 | The Affirmative Couch

Being an affirmative psychotherapist is an important and selfless job, but when you’re so caught up in caring for others, it’s easy to overlook your own well-being.

For your sake and the sake of your clients, it’s crucial to take the occasional step back to focus on your own needs. Here are five essential self-care [...]

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Non-binary Microaggressions in Psychotherapy

Posted: 9-24-21 | Nicholas Moran

COVID-19 & (Re)claiming Gender

As a non-binary, genderqueer, and trans femme therapist myself, I have encountered my own fair share of microaggressions related to gender identity. During the pandemic, I have witnessed many people for the first time in their lives take a break from performing gender in a way society deems acceptable. As [...]

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Making the most of your clinic’s power

Posted: 9-1-21 | Melissa Dellens

Organizational empowerment is an active and participatory process through which individuals, organizations, and communities gain greater control, efficacy, and social justice (Peterson & Zimmerman, 2004). Firstly, we explored Brofenbrenner’s ecological model (Hess & Schultz, 2008), and Prillelensky’s (2008) understanding of power dynamics.  Secondly, we will introduce organizational empowerment theory (Peterson & Zimmerman, 2004) and [...]

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Therapy with Black Gay Men addicted to meth

Posted: 8-18-21 | Jerry St. Louis, LGSW

To be a Black Gay Man with an addiction to crystal meth, is to be stuck between to worlds. This article will explore ways that psychotherapists can provide affirmative therapy with Black Gay men addicted to methamphetamines. The first two articles of this series, Affirmative Therapy: Crystal Meth in the Black Gay Community and [...]

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Defining Power for Affirmative Therapists

Posted: 8-4-21 | Melissa Dellens

Clinics, treatment centers, and group practices play an important role in the communities they serve. Power flows through every relationship from the individual dyad in treatment to a community clinic’s relationship with federal policy (Hess & Schultz, 2008).  Moreover, these dynamics can be seen as both a commodity and resource (Peterson & Zimmerman, 2004) in [...]

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Bisexual Polyamorous Clients in Therapy

Posted: 7-21-21 | Stephanie Sullivan

Before getting into this article, I would like to locate myself. I am a white, bisexual, able-bodied, ambiamorous, cisgender woman with anxiety and a chronic illness who has been in both monogamous and polyamorous relationships. As someone who identifies as bisexual, has navigated both polyamorous and monogamous relationships, and specializes in working with these [...]

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Kink-Aware Therapist: Challenging Your Awareness

Posted: 7-7-21 | Rachel Gombos

Please note that this article contains content related to sexual trauma.

Together, we have journeyed through the previous articles in this series towards becoming a kink-aware therapist, Depathologizing Kink in Therapy and Kink-Aware Therapy: Consent and Negotiation to discuss kink practices and understand the consent and negotiation tactics that govern them. Buehler (2017) [...]

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4 Barriers to Affirmative Clinic Change

Posted: 6-9-21 | Melissa Dellens

Gerald Caplan is seminal in developing some of the early theories of consulting work (Caplan, 1960). Caplan worked in Israel after World War II providing mental health support to 16,000 displaced and orphaned teens in overwhelmed residential and refugee facilities (Mendoza, 1993). Caplan’s resources were limited, and his team had no way of serving the [...]

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